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. 2024 Dec;74(6):1405-1412.
doi: 10.1016/j.identj.2024.05.005. Epub 2024 Jun 8.

Dental Pulp Vascular Response to Early Stages of Caries

Aljaž Golež  1 , Ksenija Cankar  2 , Aleksandra Milutinović  3 , Lidija Nemeth  4 , Ana Tenyi  4
Affiliations

Dental Pulp Vascular Response to Early Stages of Caries

Aljaž Golež et al. Int Dent J. 2024 Dec.

Abstract

Objectives: During caries progression, dental pulp is increasingly pathologically affected. Since the accurate assessment of pulp is of vital importance in clinical decision-making, this study aimed to evaluate pulpal condition in the early stages of caries via laser Doppler (LD) flowmetry and histologic analysis and determine their agreement.

Methods: Fourteen patients with severe dental crowding were included. Prior to extractions and orthodontic treatment, dental pulp condition of 52 premolars was evaluated via LD flowmetry. Teeth were assessed for the presence of caries and lesions were graded according to the International Caries Detection and Assessment System (ICDAS). After extractions, teeth were split and histologically stained for endothelial cells with anti-von Willebrand factor and Movat pentachrome for collagen. Volume densities of vessels (Vvasc) and collagen were calculated.

Results: There was a significant negative correlation between LD flow and Vvasc of the dental pulp with ICDAS grade. Pulpal LD flow and Vvasc in teeth with the initial lesion were increased, decreasing with progressing stages of caries. A significant positive correlation between the the pulpal LD flow and Vvasc, and a negative correlation of LD flow with collagen fibre density were noted.

Conclusions: Caries affects the physiology of the dental pulp, initially with increasing vascularity, and decreasing vascularity at later stges of caries progression. Collagen contents increase with grades of ICDAS. LD flow shows good agreement with the histologic constitution of the dental pulp. Use of clinical measurements of pulpal LD flow could provide a good noninvasive indication of pulpal vascular state and its health.

Keywords: Caries; Collagen fibres; Dental pulp; Laser Doppler flow; Vitality test; Volume density of blood vessels.

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Conflict of interest statement

Conflict of interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig 1
Fig. 1
Dental pulp stained with anti–von Willebrand factor (objective magnification 10×, bar = 100 μm). Note that the pulp tissue is significantly more vascularised in the International Caries Detection and Assessment System (ICDAS) 1 group (B) in comparison to groups ICDAS 0 (A), ICDAS 2 (C), and ICDAS 3 (D).
Fig 2
Fig. 2
Correlation between pulpal (A) vascular volume density and laser Doppler (LD) flow and (B) collagen volume density and LD flow.
Fig 3
Fig. 3
The odontoblast layer and Weil and Höhl zone; note the area where the odontoblast layer was torn off when the pulp was isolated from dentine (↑↑).
See this image and copyright information in PMC

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